This article is a Q&A with a Pain Doctor who has had success when combining therapies.
On a personal note:
I myself have had my best "success" in dealing with my pain/conditions when I have combined various types of therapies. Although I now realize that I will probably always have to take certain medications to control the severity of my pain (intensity-levels), I am also aware that there ARE other types of holistic healing therapies that have helped in combination with the meds.
--I will elaborate more on this topic in a future blog entry.--
Physician Looks to Safest, Gentlest, Most Effective Methods to Treat Pain and Stress...
*An Interview with Woodson Merrell, MD*
Trained as an internist at Columbia Medical School, Woodson Merrell, MD, Executive Director of the Continuum Center for Health and Healing at Beth Israel Medical Center found that when he got out to practice, he lacked the tools needed to help many of his patients, particularly those with functional problems caused by stress, inadequate exercise, and poor nutrition. For his patients with more serious problems, he wanted to find modalities that could be used as adjuncts to conventional care and expand his options beyond pharmaceuticals or surgery.
Merrell trained in most of the practices included in integrative or complementary medicine, and in 1994, started one of the nations first courses in complementary and alternative medicine for medical students at Columbia. Today, as Executive Director of the 16-month-old Continuum Center for Health and Healing at Beth Israel Medical Center, he combines conventional care with alternative methods.
Merrell says, "we use whatever is safest, gentlest, and most effective for the patient regardless of what tradition it came from. As much as possible, we use an evidence-based approach, but certainly would consider an herbal remedy that's been around for twenty-five hundred years - that's a significant enough empirical trial."
Q. As a physician practicing integrated medicine, how do you view and treat pain?
Merrell: People with pain fall into many categories - from those with run-of-the-mill temporary types of pain to those with severe, crippling neurologic problems. I usually get patients in the earlier stages where the problems are less severe. For those patients, I try to use modalities that will nip their pain in the bud without having to risk the side effects of pharmaceuticals. As physician practicing integrated medicine, I encourage the use of all gentle remedies that can help reduce a person's pain and hopefully eliminate the need for more drastic forms of treatment.
"But, I have no problems prescribing opioids when needed".
Q. What are some of the most effective ways people can address their stress and pain?
Merrell: We need to address the causes of stress. If someone's in the middle of a divorce or a horrible home situation, for example, cognitive behavioral therapy can be a very valuable tool. In terms of what people can do on their own, first, they should eliminate bad habits that are often used to relieve stress, but are really harmful such as drinking too much coffee or alcohol, smoking cigarettes, and eating comfort foods. These may be rewarding in the short term, but whenused as a perpetual remedy, they seriously contribute to the problem.
They should also consider pursuing activities that are rewarding, satisfying, and relaxing such as walking in the park, listening to Bach, playing a sport. Group social support is also extremely beneficial. Group therapy can help, but so can talking with friends and loved ones.
Mind-body techniques are the most powerful way to reduce stress in the long-term. And of those techniques, meditation is the most effective way of all. It can change physiologic functioning. Meditation that is spiritually-focused has been shown to have even more dramatic effects. For many people it's often hard to meditate - and the people who need it the most often have the greatest trouble. They're either bothered by problems in the past or worrying about the future. They have trouble focusing on the present moment - which is where they have to be.
Imagery can also be useful. It is a conscious meditation technique. You focus on something you want to change within - whether its pain or a tumor. Hypnosis and biofeedback are also useful mind-body techniques. But, these are different from meditation because they are conscious-focusing exercise.
Meditation is a way of disengaging conscious thought processes and going to a much deeper place of relaxation. People can do mind-body techniques on their own, but would benefit by going to someone who can teach them how to do it and set practices in the beginning.
Q. Let's get back to mind-body medicine. Can you give a brief description of what it is?
Merrell: The mind and body are inseparable - they are one. Every cell has an immediate feedback from the brain and nervous system - so there is no separation - it's a false distinction.
The mind is the most powerful healing tool. Mind-body approaches allow us to realize the full potential of the mind in producing a change in how you think, feel, and act - whether emotional spiritual, or physical.
Q. As a trained acupuncturist, will you describe the benefits of this treatment for stress and pain?
Merrell: Acupuncture forces the nervous system to relax. It raises endorphins and mitigates the pain. It can actually help heal some pain syndromes - it doesn't heal a herniated disk - but it can reduce the level of pain you feel. And it can produce an instant deep meditation - give a jump start to the process and show people what they're capable of. Sit them down, plug them in, and let the endorphins do their thing.
Acupuncture is very underutilized by conventional medicine. It's a gentle tool for helping control pain and stress. But mind-body is easier because you can meet with a teacher two or three times and then go off and do it yourself. With acupuncture, you have to continue visits and paying. Mind-body is the most powerful in the long term.
Q. How do you see your role as a physician?
Merrell: The physician should be looked at as an educator and partner in helping the patient find the best modalities for optimum health. It's also vital that the patient is engaged in the process.
The mind is the most powerful healing tool.
Last Updated: 08/10/09